← CMS Doctors and Clinicians
JEFFREY W WALLACE, PA
PHYSICIAN ASSISTANT · LAKE SAINT LOUIS, MO
Provider
- NPI
1649479171- Credential
- PA
- Primary specialty
- PHYSICIAN ASSISTANT
- Gender
- Male
- Medical school
- OTHER
- Graduation year
- 2004
Practice
- Address
- 100 MEDICAL PLZ, LAKE SAINT LOUIS, MO 633671366
- Phone
- 6366255200
- Accepts Medicare
- Yes (individual)
- Telehealth
- No
Source
- Authoritative
- NPI Registry
- Machine
- JSON-LD · Markdown